OPS/MCI

Question 1

EMS Roles and Responsibilities

Answer 1

Preparation 
Response
Scene management
Patient assessment and prehospital care
Management and Disposition 
Patient Transfer
Documentation
Return to Service

Question 2

EMS medical director roles

Answer 2

Education and training
Participate in selection of personnel
Participate in equipment selection 
Develop clinical protocols
Quality improvement 
Provide input into care
Interface among EMS systems
EMS advocacy to community
Medical conscience to EMS

Question 3

Protocol

Answer 3

Treatment plan for specific illness or injury

Question 4

Standing order

Answer 4

Type of protocol that is a written document signed by the EMS medical director that outlines specific directions, permissions, and sometimes prohibitions.

Question 5

Continuous Quality Improvement

Answer 5

Improves systems quality by including:
ID system wide problems
Conduct in-depth review of problems
Aid the problems and develop remedies
Develop action plan for correcting problems
Enforce the plan of action
Re-examine the problem
ID excellence in pt care
Look for modifications for standing orders
ID situation not covered by protocols/standing orders

Question 6

Descriptive research

Answer 6

Research that is basically an observation only. No attempt to change or alter an event occurs.

Question 7

Experimental research

Answer 7

When a skill, new product, or general idea is used in a trial phase, and the effects are evaluated.

Question 8

Prospective research

Answer 8

Research that defines a clear problem or question prior to gathering data

Question 9

Cross-sectional research

Answer 9

Research that is based on a group of people over an outlined time frame.

Question 10

Format for research projects

Answer 10

Intro
Methods
Results
Discussion
Conclusion

Question 11

10 steps to conducting a research project

Answer 11

Prepare a question
Write a hypothesis
Decide what to measure and method to use
Outline the population
ID study limitations
Acquire approval from ethics board
Obtain consent from population used
Gather data
Analyze data
Decide what to do with final research product.

Question 12

Defence mechanisms for psychological stress

Answer 12

Denial
Regression
Projection
Displacement

Question 13

Stages of the grieving process

Answer 13

Denial
Anger
Bargaining
Depression
Acceptance

Question 14

Criteria for level 1 trauma centre referral: Vitals and anatomic criteria

Answer 14

GCS: 13 or less; SBP <90;
Penetrating Injury to head, neck, torso, proximal extremities; flail chest; 2 or more proximal long bone fx; crushed, degloved, mangled extremity; amputation proximal to wrist/ankle; pelvic fx; open/depressed skull fx; paralysis.

Question 15

Criteria for trauma centre referral: MOI that does not necessarily require lvl 1 depending on examination

Answer 15

Falls >6m (adult), >3m (child); auto collision: >35 cm intrusion (occupants) or >55cm anywhere; ejection; death in compartment; vehicle data consistent w/ high risk;
Pedstruck >35km; motorcycle >35km.

Question 16

MOI evidence of high-energy trauma: referral to Lvl 1 trauma centre

Answer 16

Ejection from vehicle; death in compartment; pedstruck >8km; initial speed of MVA >65 km; intrusion >35cm or 55cm deformity; extrication >20 min; fall > 6m; rollover (unrestrained passengers); motorcycle collision >35km with separation of rider and bike

Question 17

Special patient or system factors for level 1 trauma referral

Answer 17

Age > 55; pediatric; anticoagulant and bleeding disorders; burns with trauma; time sensitive extremity injury; renal dialysis; pregnancy > 20wks; EMS judgement; cardiac or respiratory comorbidity; T1D, cirrhosis, obesity, coagulopathy.

Question 18

Incident command system roles and responsibilities

Answer 18

Command, finance, logistics, operations, planning.

Question 19

Incident commander

Answer 19

Person in charge of the overall incident. Duties include public information, safety, and liaison

Question 20

Finance chief responsibility in MCI

Answer 20

Documenting all expenditures for tracking and reimbursement

Question 21

Logistics responsibility in MCI

Answer 21

Communications equipment, facilities, food and water, fuel, lighting, and medical equipment and supplies for patients and responders.

Question 22

Operations section responsibility during MCI

Answer 22

Supervises people working at the scene

Question 23

Planning section responsibility during MCI

Answer 23

Obtain data about the problem, solves problems, analyzes previous incident plan

Question 24

Medical incident command

Answer 24

Medical branch of the incident command system. Medical incident command supervises the primary roles of: triage, treatment, and transport.

Question 25

Triage unit tasks

Answer 25

Initial assessment, tagging, and triaging of all patients. Help move patients to appropriate treatment centre. Do not begin treatment until all patients have been triaged.

Question 26

Treatment unit tasks

Answer 26

Locate and set up treatment area with a tier for each patient. Provide treatment for patients, and help move patients to the transport area.

Question 27

Transportation unit tasks in MCI

Answer 27

Coordinate transportation and distribution of patients to receiving hospitals.

Question 28

Staging officer tasks at MCI

Answer 28

Establish a staging area for emergency vehicles or agencies. Coordinate plan to prevent traffic congestion and release vehicles and supplies when ordered by command.

Question 29

Rehabilitation officer tasks in an MCI

Answer 29

Facilitate responder rest, fluids, food, and protection from the elements. Monitor responders for signs of stress or exhaustion

Question 30

Primary triage

Answer 30

The initial triage done in the prehospital environment. Patients are briefly assessed and identified in some way such as a triage tag.

Question 31

Secondary triage

Answer 31

Done as patients are brought to the treatment area.

Question 32

Red triage tag category (priority)

Answer 32

Airway and breathing difficulties 
Uncontrolled or severe bleeding
Severe medical problems
Shock
Severe burn
Open chest or abdominal injury

Question 33

Yellow tag triage priority (delayed)

Answer 33

Burns without airway problems
Major or multiple bone or joint injury
Back injury with or without spinal cord damage

Question 34

Green tag triage priority (walking wounded)

Answer 34

Minor fractures

Minor soft tissue injuries

Question 35

Black tag triage priorities (expectant)

Answer 35

Obvious death
Obviously insurvivable injury, such as open brain trauma
Respiratory arrest (if limited resources)
Cardiac arrest

Question 36

START triage red (priority) category

Answer 36

RR greater than 30 or less than 10
Absent or weak, irregular radial pulse
Unable to follow commands

Any or all of the following are immediate (red)

Question 37

START triage yellow category

Answer 37

RR between 10 and 30
Strong radial pulse
Follows simple commands
Unable to walk

Question 38

START triage green category

Answer 38

Walking wounded

Question 39

JumpSTART triage

Answer 39

Used for children younger than 8 or who appear to weigh less than 45kg.
Not breathing but has a pulse: open airway. If still apneic, give 5 breaths and assess again. If still apneic, label black.
RR less than 15 or more than 45: label red
Absent or weak, irreg distal pulse: label red
Unresponsive, postures to pn, incomprehensible sounds: label red
Localizes or withdraws from pn: label yellow